Graduates of Christian Medical College (CMC), Vellore, India, have a 2-year service obligation to work in small hospitals mainly located in rural areas. The Fellowship in Secondary Hospital Medicine (FSHM) program is a year-long blended on-site and distance learning program, designed by CMC to support and provide education opportunities for its recent graduates working in small hospitals in rural areas. The FSHM program was designed to help junior doctors develop the knowledge and skills to practice effectively in rural hospitals.